Distributed flow path insufflation

ABSTRACT

A system includes a bypass valve, a first conduit, and a second conduit. The bypass valve includes at least a first channel and a second channel and is configured to permit insufflation fluid to flow along a first flow path when the second channel is closed and permit the insufflation fluid to flow along a second flow path when the first channel is closed. The first conduit is coupled to the bypass valve and is configured to facilitate delivery of the insufflation fluid from an insufflator to the bypass valve. The second conduit is coupled to the first channel of the bypass valve and configured to facilitate delivery of the insufflation fluid from the bypass valve to the patient cavity via a first medical appliance.

TECHNICAL FIELD OF THE INVENTION

The present invention disclosure relates generally to medical proceduresand more particularly to a method and system for insufflating a patientcavity using a distributed flow path.

BACKGROUND OF THE INVENTION

Providing an insufflation gas into a body cavity is referred to asinsufflation. The purpose of insufflation is to inflate or distend thebody cavity to allow a surgeon to explore a surgical site and/orotherwise provide a view of the site to be treated or observed.Insufflation is used in many common procedures including endoscopicsurgical procedures, laparoscopic procedures performed on the abdominalcavity and orthoscopic procedures performed on the chest cavity.Additional medical access devices (e.g., trocars) can be used during thesame surgical procedure to remove surgical smoke from the patient cavityor to continuously measure pressure within the body cavity.

As described in U.S. Pat. Nos. 5,411,474, 6,068,609, and 7,066,902(incorporated by reference herein), insufflation gas is typicallytreated before being delivered to a patient cavity. Briefly, aninsufflation gas is heated and hydrated (i.e., conditioned) before beingdirected, in some cases, by a trocar into a patient cavity. In order tohydrate the insufflation gas a charge of hydration fluid is typicallyinjected into a device where the hydration fluid can humidify theinsufflation gas and a heater can bring the insufflation gas to atemperature near body temperature. The conditioned insufflation gas isthen delivered to a medical appliance (e.g., a trocar) for injectioninto a body cavity of a patient.

SUMMARY OF THE INVENTION

According to one embodiment, a system includes a bypass valve, a firstconduit, and a second conduit. The bypass valve includes at least afirst channel and a second channel, the first channel defining a portionof a first flow path for insufflation fluid and the second channeldefining a first portion of a second flow path for the insufflationfluid. The bypass valve is configured to permit the insufflation fluidto flow along the first flow path when the second channel is closed andpermit the insufflation fluid to flow along the second flow path whenthe first channel is closed. The first conduit is coupled to the bypassvalve and is configured to facilitate delivery of the insufflation fluidfrom an insufflator to the bypass valve. The second conduit is coupledto the first channel of the bypass valve and is configured to facilitatedelivery of the insufflation fluid from the bypass valve to the patientcavity via a first medical appliance.

According to another embodiment, a method for insufflating a body cavitywith insufflation fluid includes determining, by an insufflator, a firstpressure measurement indicative of a pressure of a patient cavity andsupplying, by the insufflator, the insufflation fluid to the patientcavity based on the first pressure measurement, wherein the insufflationfluid is supplied according to a first setting which comprises at leasta first volume and a first pressure. Supplying the insufflation fluid tothe patient cavity includes directing the insufflation fluid through afirst conduit to a bypass valve, the bypass valve including at least afirst channel and a second channel defining a portion of a first flowpath and first portion of a second flow path, respectively. Supplyingthe insufflation fluid to the patient cavity further includes directingthe insufflation fluid to the patient cavity via the first flow pathwhen the second channel is closed, wherein the first flow path isfurther defined by a second conduit coupling the first channel of thebypass valve to a first medical appliance, and directing theinsufflation fluid to the patient cavity via the second flow path whenthe first channel is closed, wherein the second flow path is furtherdefined by a second conduit coupling the second channel of the bypassvalve to a second medical appliance

According to yet another embodiment, a system includes an insufflator, abypass valve, a first conduit, a second conduit, and a third conduit.The bypass valve includes at least a first channel and a second channel,the first channel defining a portion of a first flow path for theinsufflation fluid and the second channel defining a portion of a secondflow path for the insufflation fluid, wherein: the bypass valve isconfigured to permit the insufflation fluid to flow along the first flowpath when the second channel is closed; and the bypass valve isconfigured to permit the insufflation fluid to flow along the secondflow path when the first channel is closed. The first conduit is coupledto the bypass valve and configured to facilitate delivery of theinsufflation fluid from the insufflator to the bypass valve. The secondconduit is coupled to the first channel of the bypass valve and isconfigured to facilitate delivery of the insufflation fluid from thebypass valve to the patient cavity via a first medical appliance. Thethird conduit is coupled to the second channel of the bypass valve andis configured to facilitate delivery of the insufflation fluid from thebypass valve to the patient cavity via a second medical appliance.

The teachings of the disclosure provide one or more technicaladvantages. Embodiments of the disclosure may have none, some, or all ofthese advantages. For example, in some embodiments, a method allows forthe continuous monitoring of pressure associated with a patient cavityduring and after insufflation of the patient cavity. Continuousmonitoring may result in decreased potential for physician harmresulting from insufflation fluid leakage and thus may also result in anincrease in physician confidence while performing surgical procedures.As another example, a method provides for intelligent pressuremonitoring wherein pressure sensors are automatically disabled when notin use. Thus, the intelligent pressure monitoring feature is associatedwith a reduction in power and computing resources. As yet anotherexample, a method provides for the elimination of duplicate insufflationcomponents (e.g., insufflator and conduits connecting to insufflationdelivery device such as an insufflation needle or trocar). Otheradvantages will be apparent to those of skill in the art.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of embodiments of the disclosure andthe potential advantages thereof, reference is now made to the followingwritten description taken in conjunction with the accompanying drawings,in which:

FIG. 1 illustrates an example of an insufflation system comprising aninsufflator, a trocar, an insufflation needle, and a valve, according tocertain embodiments of the present invention;

FIG. 2 illustrates the valve of the system of FIG. 1 , according tocertain embodiments of the present invention;

FIG. 3 is a flow chart illustrating a method of insufflating a patientcavity using the valve of FIG. 2 , according to one embodiment of thepresent invention;

and

FIG. 4 illustrates an example controller operable to control one or morecomponents of system 100, including the insufflator of FIG. 1 .

DETAILED DESCRIPTION OF THE INVENTION

One of the requirements for delivery of insufflation gas to a patient'sbody cavity is to maintain the proper flow of insufflation gas into thebody cavity. Normally, gas flows from a high-pressure gas source, whichis remote from the patient, through an insufflation device and finallyinto a trocar where the gas is injected into the patient's body cavity.Typically, the insufflation gas is stored in high-pressure containersand a pressure regulator reduces the pressure of the gas to a lowerpressure. The low pressure gas is typically delivered to the trocarthrough an insufflation device containing a set of inline end connectorsthat couple the source of insufflation gas, the pressure regulator, thefilter, the heater, the hydrator, and the trocar to each other.Typically, before being delivered to the patient cavity, theinsufflation gas is conditioned by filtering, heating and/or hydrating.The insufflation gas may flow through any suitable number of inline endconnectors, which are typically connected by flexible tubing (alsoreferred to herein as conduits), before being delivered to the patientcavity.

In some cases, physicians or other medical practitioners may prefer todeliver insufflation gas to patient cavity in two phases, first using afirst medical appliance (e.g., an insufflation needle) and thereafterusing second medical appliance (e.g., a trocar). Delivering insufflationgas via two different medical appliances may be preferred because onemedical appliance may have a smaller profile than the other.

Conventional two-phase insufflation may be associated with variousdrawbacks. As one example, one conventional solution requires two setsof insufflation components (e.g., insufflator, conduits); one set to beused with the first medical appliance and the other set to be used withthe second medical appliance.

Applicant has previously described and patented a solution thataddresses and eliminates the need for insufflating using duplicativeinsufflation components. See U.S. Pat. No. 10,232,132 (“the '132patent”) (incorporated by reference herein). The '132 patent generallydescribes a two-stage insufflation method using a trocar-adaptor-needleassembly (i.e., coupling, using an adaptor, a trocar cannula to aninsufflation needle). At the first stage of the insufflation method,insufflation fluid is delivered through the trocar-adaptor-needleassembly; at the second stage of the insufflation method, insufflationfluid is delivered directly through the trocar cannula. Transition fromthe first stage of the insufflation method to the second stage of theinsufflation method requires disconnection of the adaptor and needlefrom the trocar-adaptor-needle assembly. Although such adaptoreliminates the need for duplicative insufflation components, suchdelivery method is not a perfect solution. Notably, disconnection of theadaptor and needle from trocar-adaptor-needle assembly requires theremoval of the trocar-adaptor-needle from the patient cavity. In theperiod of time that it takes to remove the trocar-adaptor-needleassembly, modify the trocar-adaptor-needle assembly, and thereafterposition and insert the trocar in the patient cavity, leakage of theinsufflation fluid may occur. Any leakage of the insufflation fluidresults in deflation of the patient cavity and therefore diminishes thephysician's view of the site of interest. As will be recognized by thoseof skill in the art, inserting a trocar into a patient cavity that isnot sufficiently inflated is risky as the trocar may pierce or otherwisedamage organs surrounding the site of interest.

Other conventional two-phase insufflation solutions also experience thesame leakage risk due to disconnection and reconnection of components.For example, a popular two-phase insufflation solution involvesinitially insufflating using a first medical appliance (e.g., aninsufflation needle) connected to a conduit, that is in turn connectedto the insufflator. Once the patient cavity is sufficiently insufflatedusing the first medical appliance, the conduit is disconnected from thefirst medical appliance and connected to a second medical appliance(e.g., a trocar). As one of ordinary skill in the art will recognize,disconnection and reconnection of the conduit to the first and secondmedical appliance, respectively, presents an opportunity forinsufflation gas leakage and therefore also poses an increased risk ofthe medical procedure to the patient.

The present disclosure describes an insufflation system and method thatovercomes the shortcomings of the conventional insufflation solutionsdescribed above. In particular, the present disclosure describes aninsufflation system and method that operates using a single set ofinsufflation components and reduces or eliminates leakage ofinsufflation gas during the insufflation process, in one embodiment. Theinsufflation system and method described herein also contemplatesintelligent pressure monitoring which provides various efficiencies withrespect to time and computing resources. Example embodiments are bestunderstood by referring to FIGS. 1 through 4 of the drawings and thedescription below, like numerals being used for like and correspondingparts of the various drawings.

FIG. 1 is a schematic diagram of an insufflation system 100. In someembodiments, insufflation system 100 includes an insufflator 110,conduits 160, a valve 120, and one or more medical appliances. In theembodiment illustrated in FIG. 1 , insufflation system 100 includes afirst medical appliance (i.e., insufflation needle 130) and a secondmedical appliance (i.e., trocar 140). Other embodiments of insufflationsystem 100 may include other medical appliances. For example, in anotherembodiment, both the first and second medical appliances are trocars,the first medical appliance being a hasson trocar. As will be recognizedby one of ordinary skill, system 100 may include one or more additionalcomponents. As an example, system 100 may further include a controllerthat controls the operation of one or more components of FIG. 1 . Thisdisclosure describes and depicts an example of such controller withrespect to FIG. 4 .

Generally, FIG. 1 shows the distal end of insufflation needle 130 andtrocar 140 positioned within the abdominal cavity 150 of a patient. Ingeneral, insufflator 110 supplies insufflation gas to patient cavity150. The insufflation gas is directed from insufflator to valve 120 viaconduit 160 a and is thereafter directed to patient cavity 150 via atleast one flow path. FIG. 1 illustrates two flow paths: the first flowpath, identified in FIG. 1 as “Flow Path A,” includes conduit 160 b andinsufflation needle 130; the second flow path, identified in FIG. 1 as“Flow Path B,” includes conduit 160 c and trocar 140. As will bedescribed in further detail below, valve 120 is configured to direct theinsufflation gas to at least one of Flow Path A or Flow Path B. Inaddition to providing a flow path for insufflation gas, trocar 140permits the insertion of a surgical instrument (not illustrated) intopatient cavity 150. In the embodiment illustrated in FIG. 1 , aphysician or other medical practitioner can insert a surgical instrumentthrough an inner tubular lumen 146 of trocar 140 in order to accesspatient cavity 150 with the surgical instrument.

System 100 may further include one or more sensors 142. Sensors 142 areconfigured to measure a variable (e.g., pressure, humidity, temperature)and are, in some embodiments, communicatively coupled to othercomponents of system 100 (e.g., controller of system 100, insufflator110). Sensors 142 may be communicatively coupled to components of system100 via a wired or wireless connection. As illustrated in FIG. 1 ,sensors 142 a and 142 b communicate with insufflator 110 via cables 170a and 170 b, respectively. Communications between sensors 142 andcomponents of system 100 may include instructing sensor 142 to take ameasurement, sensor 142 reporting a measurement, instructing insufflator110 to supply insufflation gas under specified conditions (e.g., at aparticular pressure and/or volume).

As illustrated in FIG. 1 , system 100 includes three sensors: sensors142 a, 142 b, and 142 c. Sensor 142 a may be configured to (1) measure ahumidity and/or temperature of the insufflation gas as it flows throughtrocar 140; and (2) communicate such measurement(s) to insufflator 110and/or a controller of insufflation system 100. Sensors 142 b and 142 cmay be configured to (1) measure a pressure corresponding to patientcavity 150; and (2) communicate such measurement to insufflator 110and/or a controller of insufflation system 100. As will be described infurther detail below, sensor 142 b may measure a pressure correspondingto patient cavity 150 through an outer tubular lumen 144 of trocar 140and sensor 14 b may measure a pressure corresponding to patient cavity150 through Flow Path B. Although this disclosure describes and depictsonly three sensors 142, this disclosure contemplates system 100including any appropriate number of sensors.

Sensors 142 may sense pressure or a change in pressure. Sensor 142 maymeasure absolute pressure or a pressure relative to some other pressure.In some embodiments, sensor 142 is an absolute sensor that can measurepressure in patient cavity 150 (if disposed within patient cavity 150)or in the room in which the associated operation is taking place. Inparticular embodiments, sensor 142 can measure absolute barometricpressures with an accuracy of less than 1 Pascal pressure and thereforehave the ability to measure the relative changes in altitude of close toone inch. Such pressure sensors are readily available in themarketplace. Insufflator 110 of system 100 may be any suitable source ofinsufflation gas at any suitable pressure and may include a pressurizedgas source. Insufflator 110 may adjust the supply of insufflation gas topatient cavity 150 by adjusting the pressure and/or the volume ofinsufflation gas supplied to patient cavity 150. As described above,insufflator 110 may supply insufflation gas to patient cavity 150 basedon one or more pressure measurements (e.g., pressure measurements takenby sensors 142 b and/or 142 c). The insufflation gas may be any suitablegas used for insufflation purposes. As one example, insufflation gas maybe carbon dioxide.

Insufflator 110 may include any appropriate hardware and/or software forprocessing signals indicative of insufflation gas measurements andprocessing such signals to convert them into useful information, such asconverting them into pressures, heights, and/or other data that can beused control the flow of insufflation gas to patient cavity 150, andfurther for processing such data to determine a desired pressure and/orvolume of insufflation gas supplied to patient cavity 150 and foreffecting such delivery. Accordingly, insufflator 110 may include atleast one processor, a computer-readable medium to store instructions,and at least one communication interface for receiving and sendinginformation. In some embodiments, insufflator 110 includes a controllersuch as the controller 400 described and depicted in FIG. 4 .

As described above, system 100 includes valve 120. Valve 120 may be anysuitable device configured to direct insufflation gas along two or moreflow paths. As illustrated in FIGS. 1 & 2 , valve 120 is configured todischarge insufflation gas to one of two flow paths: Flow Path A andFlow Path B. Insufflation gas carried via Flow Path A is discharged fromvalve 120 to conduit 160 b and is thereafter directed through a firstmedical appliance (e.g., insufflation needle 130) to patient cavity 150.In contrast, insufflation gas carried via Flow Path B is discharged fromvalve 120 to conduit 160 c and is thereafter directed through a secondmedical appliance (e.g., trocar 140) to patient cavity 150. Valve 120 isfurther described in reference to FIG. 2 .

As described above, conduits 160 may direct the flow of insufflation gasbetween components of system 100. In some embodiments, conduits 160couple to ports located on such components. For example, as illustratedin FIG. 1 , conduit 160 a is coupled on one end to a port correspondingto insufflator 110 and is coupled on the opposite end to a portcorresponding to valve 120. As another example, conduit 160 b is coupledon one end to a port corresponding to valve 120 and is coupled on theopposite end to a port corresponding to insufflation needle 130. As yetanother example, conduit 160 c is coupled on one end to a portcorresponding to valve 120 and is coupled on the opposite end to a portcorresponding to trocar 140.

Conduits 160 may comprise any suitable material that facilitates thetransport of insufflation gas. As an example, conduits 160 may compriseflexible PVC tubing. In some embodiments, in addition to providing apathway for transporting insufflation gas, conduits 160 provide apathway for taking pressure measurements. As an example, sensor 142 cmay take a pressure measurement indicative of a pressure of patientcavity 150 via conduits 160 a and 160 b. As will be understood by one ofordinary skill in the art, pressure measurements indicative of thepressure of body cavity 150 may be taken via Flow Path A wheninsufflator 110 is not supplying insufflation gas. Although system 100is described and depicted as having only three conduits 160, thisdisclosure contemplates system 100 including any suitable number ofconduits 140.

As described above, system 100 includes trocar 140. Although system 100is described and depicted as only having a single trocar (trocar 140),this disclosure contemplates system 100 including any suitable number oftrocars 140. Trocar 140 may be any suitable trocar through whichinsufflation gas may be supplied to a patient cavity. Examples of one ormore trocars are provided in U.S. Pat. No. 8,715,219 (the '219 patent),U.S. Pat. No. 7,285,112 (the '112 patent), and U.S. Pat. No. 8,216,189(the '189 patent), which are hereby incorporated by reference as iffully set forth herein. Trocar 140 may have a single lumen or may beformed with an inner tubular lumen and an outer tubular lumen such thatinsufflation gas may be supplied through one of the lumens but not theother. Further, any of the lumens may be divided into multiple, separatechambers, such that gas in one chamber does not enter the other chamber.Examples of the above multiple lumens and multiple chambered trocars aredescribed in U.S. application Ser. No. 14/792,873, entitled “Method andSystem for Gas Maintenance to a Body Cavity Using a Trocar,” which ishereby incorporated by reference. Trocar may be open or closed at thedistal end, as the application of the trocar would allow.

As illustrated in FIG. 1 , trocar 140 includes an outer tubular lumen144 disposed about an inner tubular lumen 146. Medical instruments(e.g., scope, grasper, scissors) may be inserted through inner tubularlumen 146 of trocar 140 in order to access the site of interest withinbody cavity 150.

In some embodiments, outer tubular lumen 144 is divided into two or morechambers (e.g., chamber 144 a and chamber 144 b). The division of outertubular lumen 144 into separate chambers may provide benefits which willbe recognized by one of ordinary skill in the art. As an example, bydividing outer tubular lumen 144 into two or more chambers, trocar 140can deliver insufflation gas to patient cavity 150 while also measuringa pressure (e.g., using sensor 142) indicative of a pressure of patientcavity 150. As shown in FIG. 1 , conduit 160 c directs insufflation gasto chamber 144 a of trocar 140 where it is thereafter directed, viaapertures 148 a, to patient cavity 150. As is also shown in FIG. 1 ,apertures 148 b provide a path into chamber 144 b of trocar 140 in whichsensor 142 b may take a pressure measurement indicative of a pressure ofpatient cavity 150. Although trocar 140 is depicted in FIG. 1 as havingtwo apertures 148 a and two aperture 148 b, this disclosure recognizesthat trocar 140 may include any suitable number of apertures 148 a and148 b.

As described above, trocar 140 may include any suitable number ofsensors 142, one or more of which may be capable of taking pressuremeasurements. Sensors 142 may be located anywhere in, on, or throughtrocar 140. In some embodiments, sensors 142 are located on the exteriorof trocar 140 such that changes of pressure within trocar 140 (e.g., dueto the supply of insufflation gas to patient cavity 150) do not affectthe pressure measured by sensor 142. As described above, sensors 142 maybe absolute pressure sensors that can measure pressure in patient cavity150 (if disposed within patient cavity 150) or in the room in which theassociated operation is taking place.

Sensors 142 may be coupled to components of system 100 through anysuitable technique, including a wireless or a wired connection (e.g.,cables 170 a and 170 b). Sensor 142 supplies pressure data to acontroller of system 100, which may be comprised within insufflator 110.In such an embodiment, insufflator 110 uses this pressure data tocontrol the supply on insufflation gas by insufflator 110. In particularembodiments, this may include determining the change in height of trocar140 relative to changes in cavity pressure and thus the resulting changein height of patient cavity 150, as described in greater detail inco-pending application Ser. No. 15/293,013 entitled Method and Systemfor Controlling Pressurization of a Patient Cavity Using CavityDistension Measured by a Pressure Sensor of a Trocar incorporated hereinby reference.

Generally, system 100 is used to insufflate patient cavity 150. Uponcoupling conduits 160 to components of system 100 as illustrated in FIG.1 , insufflation may begin. In some embodiments, insufflation needle 130and trocar 140 are inserted into patient cavity 150 and valve 120 isopened such that insufflation gas can be delivered via Flow Path A.Insufflator 110 may then be turned on such that insufflation gas isdelivered to patient cavity 150 via Flow Path A. Before and/or duringinsufflation, one or more measurements are taken by sensors 142 andrelayed to insufflator 110 as described above. As is also describedabove, insufflator 110 supplies insufflation gas to patient cavity 150based on measurements taken by sensors 142. Once patient cavity 150 hasbeen insufflated to desired levels (e.g., 15 mmHg), valve 120 isadjusted to permit the flow of insufflation gas along Flow Path B suchthat insufflation gas is delivered to patient cavity 150 through trocar140.

This disclosure recognizes that each component of system 100 does notneed to be coupled in order to begin insufflation. As an example,insufflation gas may be delivered along Flow Path A without firstcoupling conduit 160 c to trocar 140. To ensure efficiency benefits,conduit 160 c is coupled to valve 120 and trocar 140 before valve 120 isadjusted to permit insufflation fluid to flow along Flow Path B. Inother words, system 100 may be assembled during or after use of one ormore components of system 100.

Furthermore, system 100 may be disassembled during or after use of oneor more components of system 100. For example, upon insufflating patientcavity 150 with insufflation needle 130 and adjusting valve 120 toprevent insufflation gas from flowing along Flow Path A (or otherwisepermit the flow of insufflation gas along Flow Path B), conduit 160 band insufflation needle 130 may be removed from system 100.

This disclosure describes valve 120 in further detail with respect toFIG. 2 and describes certain methods of insufflating a patient cavitywith respect to FIG. 3 . Finally, this disclosure describes details of acontroller of system 100 with respect to FIG. 4 .

FIG. 2 illustrates one embodiment of valve 120. As shown in FIG. 2 ,valve 120 is a ball valve that provides multiple flow paths. Althoughthis disclosure describes and depicts valve 120 as a ball valve, thisdisclosure recognizes that valve 120 may be any suitable type of valve120 that provides multiple flow paths for insufflation gas. For theavoidance of doubt, this disclosure recognizes valve 120 being anysuitable solenoid or pneumatic valve.

As illustrated in FIG. 2 , valve 120 includes handle 210, inlet 220, afirst outlet 230, a second outlet 240, and a ball 260. Generally, ball260 is rotated within valve 120 based on movements of handle 210. One ormore channels 250 within valve 120 may be opened as ball 260 rotateswithin valve 120. As one example, turning handle 210 90° may openchannel 250 a and close channel 250 b. As a result of turning handle 21090°, insufflation gas may be permitted to flow into inlet 220 and out ofvalve 120 via outlet 230. As another example, turning handle 210 180°may open channel 250 b and close channel 250 a. As a result of turninghandle 210 180°, insufflation gas may be permitted to flow into inlet220 and out of valve 120 via outlet 240. As yet another example, turninghandle 210 270° may close two or more channels 250 (e.g., 250 a and 250b) such that insufflation gas cannot flow along Flow Path A or Flow PathB (or insufflation gas is otherwise blocked from flowing into inlet 220of valve 120). In some embodiments, turning handle 210 360° may open twoor more channels 250 (e.g., 250 a and 250 b) such that insufflation gasis permitted to flow along Flow Path A and Flow Path B. Although thisdisclosure describes various settings for valve 120, this disclosurecontemplates valve 120 including any desirable valve setting thatpermits insufflation gas to flow (or not flow) through one or morecomponents of system 100.

In some embodiments, conduit 160 a is coupled to inlet 220 to permit theflow of insufflation gas from insufflator 110 to valve 120. In someembodiments, conduit 160 b is coupled to outlet 230 to permit the flowof insufflation gas along Flow Path A and conduit 160 c is coupled tooutlet 240 to permit the flow of insufflation gas along Flow Path B.Accordingly, this disclosure recognizes that turning handle 210 maypermit insufflation gas to flow along Flow Path A and/or Flow Path B.

In some embodiments, valve 120 does not include handle 210 to controlactuation of ball 260. Instead, ball 260 (or other suitable valvemechanism for blocking, or otherwise closing, channels 250) may actuatebased on receipt of instructions from a controller (e.g., controller 400of FIG. 4 ). As described above, controller may be comprised withininsufflator 110. In other embodiments, such controller may be externalto insufflator 110. In some embodiments, controller is programmed toactuate ball 260 (or other suitable valve mechanism for blocking, orotherwise closing, channels 250) in a manner that closes one flow path(e.g., Flow Path A) and opens another flow path (e.g., Flow Path B) inresponse to determining that desired levels of insufflation gas havebeen attained (e.g., when patient cavity 150 has been insufflated to 15mmHg). In this manner, insufflation gas may be continuously delivered topatient cavity 150 even though the flow path for the insufflation gashas changed. As will be recognized by one or ordinary skill, continuousflow of insufflation gas may result in certain benefits relative toconventional insufflation system, including reducing or eliminatingleakage of insufflation gas.

FIG. 3 is a flow chart illustrating a method 300 of insufflating apatient cavity using system 100. The method may utilize structural itemssuch as those described in FIGS. 1 through 2 or may use alternativestructural items. Computational steps described below may be performedby any suitable computation device, including a controller that may ormay not be a subcomponent of insufflator 110.

The method 300 begins at step 305 and continues to step 310. At step310, system 100 measures a pressure indicative of a pressure of patientcavity 150. In some embodiments, the pressure measurement taken at step310 is measured by one or more sensors 142. As described above, sensors142 may be located in, on, or through trocar 140 and/or insufflator 110.In some embodiments, sensors 142 may continuously measure a pressurewithin patient cavity 150 and communicate a signal indicative of themeasurement(s) to the controller of system 100.

In some embodiments, one or more pressure measurements are taken bysensor 142 b and communicated to a controller (e.g., controller 400 ofFIG. 4 . In such embodiment, gas may enter into outer chamber 144 b oftrocar 140 through apertures 148 b so that the pressure of the gas maybe measured by sensor 142 b. In other embodiments, one or more pressuremeasurements are taken by sensor 142 c collocated with insufflator 110.As will be recognized by those of ordinary skill, to ensure the accuracyof the reading, pressure measurements using sensor 142 c should occurwhen insufflator 110 is not supplying insufflation gas to patient cavity150. Although this disclosure describes and depicts particular positionsin system 100 for sensors 142, this disclosure recognizes that sensors142 may be located in any suitable position that would permit sensors142 to measure pressure indicative of a pressure of patient cavity 150.Once system 100 determines such pressure measurement(s), the method 300may proceed to step 320.

At step 320, system 100 supplies insufflation gas to patient cavity 150based on the pressure measurement taken at step 310. As an example, ifcontroller receives a pressure measurement at step 310 of 15 mmHg,controller may instruct insufflator 110 to supply 1 L/min ofinsufflation gas to patient cavity. This disclosure recognizes thatvariables other than the pressure of insufflation gas may also bemonitored and adjusted while delivering insufflation gas using system100. As an example, sensor 142 a may be configured to sense humidityand/or temperature information which is relayed to a controller thatthereafter instructs insufflator 110 to adjust the humidity and/ortemperature of the supply of insufflation gas. Once insufflation gas hasbeen supplied to patient cavity 150, the method 300 may proceed todecision step 350.

At decision step 330, system 100 determines whether first channel 250 ais open (not blocked) or closed (blocked). If at step 350, system 100determines that first channel 250 a is open, the method 300 proceeds toa step 340 a. If at step 250, system 100 instead determines that firstchannel 250 a is closed, the method 300 proceeds to a step 340 b.

At step 340 a, system 100 directs the insufflation gas to a first flowpath (e.g., Flow Path A of FIG. 1 ). At step 340 b, system 100 directsthe insufflation gas to a second flow path (e.g., Flow Path B of FIG. 1). As discussed above, it may be preferable to initially deliverinsufflation gas via a first flow path and thereafter deliverinsufflation gas via a second flow path. As described above, channels250 of valve 120 may be opened or closed manually (e.g., by turninghandle 210) and/or based on instructions provided by the controller ofsystem 100 (e.g., controller 400). To deliver insufflation gas initiallythrough insufflation needle 130 of system 100, channel 250 a should beopened and channel 250 b should be closed. Once channels are positionedas desired, insufflator 110 may discharge insufflation gas to valve 120via conduit 160 a and can thereafter be directed to insufflation needle130 via conduit 160 b (Flow Path A). In some embodiments, the method 300proceeds to an end step 345 once insufflation gas has been directed toeither the first or second flow path.

Modifications, additions, or omissions may be made to the methodsdescribed herein without departing from the scope of the disclosure. Themethods may include more, fewer, or other steps. Additionally, steps maybe performed in any suitable order. As an example alternative method,the method 300 may continue to a step whereby it is determined thatpatient cavity 150 is insufflated to a desired level (15 mmHg). Upondetermining that the desired level has been reached, channel 250 a maybe closed and channel 250 b may be opened such that insufflation gas canbe delivered along Flow Path B (rather than Flow Path A). In someembodiments, this transition may be performed automatically. Forexample, upon determining that patient cavity has a pressure of 15 mmHg,controller may instruct ball 260 (or other suitable valve mechanism forblocking, or otherwise closing, channels 250) to rotate such thatchannel 250 a is closed and channel 250 b is open.

Additionally, system 100 may also be configured to implement certainfunctionalities in response to determining that one or more channels 250of valve 120 are closed. As an example, system 100 may automaticallyadjust the operational settings of insufflator 110 in response todetermining that one channel 250 has been opened and another channel 250has been closed. In such example, insufflator may receive instructionsto adjust the volume and/or pressure of the insufflation gas beingsupplied in order to ensure that the pressure of patient cavity 150 ismaintained in response to a controller of system 100 determining thatchannel 250 a is closed. As another example, system 100 mayautomatically disable one or more sensors 142 from taking measurements(e.g., pressure measurements) in response to determining that onechannel 250 has been opened and another channel 250 has been closed. Asyet another example, in response to determining that two or morechannels 250 are closed (e.g., based on pressure measurements indicativeof the pressure of patient cavity 150), insufflator 110 may display, oninsufflator 110, a message indicating such (e.g., insufflator 110 maydisplay “OCCLUSION” or “ERROR”) In some embodiments, adjustingoperational settings of system components (e.g., sensors 142,insufflator 110) may result in efficiency and/or timing benefits.

In some embodiments, controller of system 100 determines that one ormore channels 250 are closed based on a rapid pressure raterise/decline. For example, controller may determine that channel 250 aand/or 250 b is closed by determining that the pressure within patientcavity 150 increased or decreased by 5 mmHG within 1 seconds. Althoughthis disclosure identifies particular ways of identifying whetherchannel 250 is open or closed, this disclosure recognizes thatidentifying whether channel 250 is open or closed may be determined inany suitable way.

Method 300 may also include one or more of the following steps: (1)determine that a first sensor 142 is providing inaccurate or unreliablepressure readings; and (2) to instruct insufflator 110 to supplyinsufflation gas based on measurements determined by a second sensor142. In some embodiments, controller of system 100 is responsible forperforming these steps. In some embodiments, controller of system 100analyzes pressure measurement(s) received from a first sensor 142 forindications of whether the signals are indicative of the measuredpressure being inaccurate or otherwise suggesting that first sensor 142is operating in a less than optimal manner. Any suitable factors may beconsidered in such analysis; however, certain factors that may indicatefirst sensor 142 is operating in a less than optimal manner include (1)whether the received signal is not within an expected range for thereceived signal; (2) whether error data is received, such as whethererrors have occurred due to interference from a power signal, the wrongnumber of bits have been received, data is received in the wrong format,or data is received with improper spacing (3) whether properacknowledgment bits are not received from the primary pressure sensor,(4) whether the received signal is not within an expected voltage range,(5) whether expected new updated status bits are not received, such aswhether a signal has changed enough to indicate a new measurement hasoccurred as opposed to a signal being so close to a previous signal toindicate no new measurement has occurred; and (6) in the case wheresystem 100 includes two or more pressure sensors 142, whethermeasurements by the two or more sensors 142 are not within a certainrange of each other. Upon determining that first sensor 142 is providinginaccurate or unreliable pressure readings, controller of system 100 mayinstruct insufflator 110 to supply insufflation gas based on pressurereadings from a second sensor 142. In some embodiments, first sensor 142is disabled upon determining that first sensor 142 is providinginaccurate or unreliable pressure readings. In other embodiments,pressure readings from first sensor 142 are ignored upon determiningthat first sensor 142 is providing inaccurate or unreliable pressurereadings.

The method 300 may also include one or more disassembly steps whereincomponents may be removed from system 100 (e.g., insufflation needle 130and/or conduit 160 b) although insufflation gas continues to bedelivered to patient cavity 150 (e.g., via conduit 160 c and trocar140).

Although this disclosure describes and depicts particular embodiments ofthe present invention, it will be understood that various substitutionsand alterations can be made therein without departing from the spiritand scope of the present invention, as defined by the following claims.For example, although sensors 142 have been described above as beinglocated on trocar 140 and/or insufflator 110, sensor 142 may also belocated on, in, or through other medical appliances as well. Suchmedical appliances may be or include one of: a needle, a stapler, agrasper, a pair of scissors, a scalpel, a cutter, an electrode, an endseal, a probe, a multiple access port, and a single access port.Although this disclosure identifies certain types of medical appliances(including trocars 140), this disclosure recognizes that sensor 142 maybe located on, in, or through any suitable medical appliance. Forexample, this disclosure recognizes any medical appliance that canpuncture the skin as a medical appliance.

FIG. 4 illustrates an example controller 400 of system 100, according tocertain embodiments of the present invention. As described above,controller may be internal or external to one or more components ofsystem 100. In a particular embodiment, controller is comprised withininsufflator 110. Controller 400 may comprise one or more interfaces 410,memory 420, and one or more processors 430. Interface 410 receives input(e.g., sensor data, user input), sends output (e.g., instructions),processes the input and/or output, and/or performs other suitableoperation. Interface 410 may comprise hardware and/or software.

Processor 430 may include any suitable combination of hardware andsoftware implemented in one or more modules to execute instructions andmanipulate data to perform some or all of the described functions ofcontroller 400. In some embodiments, processor 430 may include, forexample, one or more computers, one or more central processing units(CPUs), one or more microprocessors, one or more applications, one ormore application specific integrated circuits (ASICs), one or more fieldprogrammable gate arrays (FPGAs), and/or other logic.

Memory (or memory unit) 420 stores information. Memory 420 may compriseone or more non-transitory, tangible, computer-readable, and/orcomputer-executable storage media. Examples of memory 420 includecomputer memory (for example, Random Access Memory (RAM) or Read OnlyMemory (ROM)), mass storage media (for example, a hard disk), removablestorage media (for example, a Compact Disk (CD) or a Digital Video Disk(DVD)), database and/or network storage (for example, a server), and/orother computer-readable medium.

Modifications, additions, or omissions may be made to the systems,apparatuses, and methods described herein without departing from thescope of the disclosure. The components of the systems and apparatusesmay be integrated or separated. Moreover, the operations of the systemsand apparatuses may be performed by more, fewer, or other components.One skilled in the art will also understand that the system contemplatedby this disclosure can include other components that are not illustratedbut are typically included with such systems. Additionally, operationsof the systems and apparatuses may be performed using any suitable logiccomprising software, hardware, and/or other logic. As used in thisdocument, “each” refers to each member of a set or each member of asubset of a set.

Although this disclosure has been described in terms of certainembodiments, alterations and permutations of the embodiments will beapparent to those skilled in the art. Accordingly, the above descriptionof the embodiments does not constrain this disclosure. Other changes,substitutions, and alterations are possible without departing from thespirit and scope of this disclosure.

What is claimed is:
 1. A method for insufflating a body cavity withinsufflation fluid, the method comprising: determining, by a controller,a first pressure measurement indicative of a pressure of a patientcavity; supplying, by an insufflator, the insufflation fluid to thepatient cavity based on the first pressure measurement, wherein theinsufflation fluid is supplied according to a first setting, the firstsetting comprising at least a first volume and a first pressure andwherein supplying the insufflation fluid includes directing theinsufflation fluid through a first conduit to a bypass valve, the bypassvalve comprising at least a first channel and a second channel defininga portion of a first flow path and first portion of a second flow path,respectively; directing the insufflation fluid to the patient cavity viathe first flow path when the second channel is closed, wherein the firstflow path is further defined by a second conduit coupling the firstchannel of the bypass valve to a first medical appliance; and directingthe insufflation fluid to the patient cavity via the second flow pathwhen the first channel is closed, wherein the second flow path isfurther defined by a third conduit coupling the second channel of thebypass valve to a second medical appliance.
 2. The method of claim 1,further comprising: determining, by a pressure sensor of the firstappliance, the first pressure measurement.
 3. The method of claim 1,further comprising: receiving, via one or more cables coupling the firstappliance to the insufflator, the first pressure measurement determinedby the pressure sensor of the first appliance.
 4. The method of claim 1,further comprising: in response to determining that the insufflationfluid is not being supplied to the patient cavity, instructing apressure sensor of the insufflator to take the first pressuremeasurement, wherein the first pressure measurement is based oninformation delivered via the second flow path.
 5. The method of claim1, further comprising: subsequent to supplying insufflation fluid basedon the first pressure measurement, supplying the insufflation fluidbased on a second pressure measurement determined by a pressure sensorof the first appliance.
 6. The method of claim 1, further comprising:determining, by the controller, that one of the first channel or thesecond channel is closed.
 7. The method of claim 6, further comprising:in response to determining that one of the first channel or the secondchannel is closed, subsequently supplying, by the insufflator, theinsufflation fluid according to a second setting, wherein: the secondsetting comprises at least a first volume and a first pressure; and thesecond setting is different than the first setting.
 8. The method ofclaim 6, further comprising: instructing the pressure sensor of theinsufflator to take a third pressure measurement in response todetermining that the first channel is closed.
 9. The method of claim 1,further comprising: instructing, by a controller, the valve to close oneof the first channel or the second channel in response to determiningthat the pressure of the patient cavity is at or above a threshold. 10.A system comprising: a bypass valve comprising at least a first channeland a second channel, the first channel defining a portion of a firstflow path for insufflation fluid and the second channel defining a firstportion of a second flow path for the insufflation fluid, wherein: thebypass valve is configured to permit the flow of the insufflation fluidalong the first flow path when the second channel is closed; and thebypass valve is configured to permit the flow of the insufflation fluidalong the second flow path when the first channel is closed; a firstconduit coupled to the bypass valve and is configured to facilitatedelivery of the insufflation fluid from an insufflator to the bypassvalve; and a second conduit coupled to the first channel of the bypassvalve and is configured to facilitate delivery of the insufflation fluidfrom the bypass valve to the patient cavity via a first medicalappliance.
 11. The system of claim 10, wherein the first medicalappliance is a trocar.
 12. The system of claim 10, further comprising athird conduit coupled to the second channel of the bypass valve andconfigured to facilitate delivery of the insufflation fluid from thebypass valve to the patient cavity via a second medical appliance.
 13. Asystem comprising: an insufflator; a bypass valve comprising at least afirst channel and a second channel, the first channel defining a portionof a first flow path for the insufflation fluid and the second channeldefining a portion of a second flow path for the insufflation fluid,wherein: the bypass valve is configured to permit the insufflation fluidto flow along the first flow path when the second channel is closed; andthe bypass valve is configured to permit the insufflation fluid to flowalong the second flow path when the first channel is closed; a firstconduit coupled to the bypass valve and configured to facilitatedelivery of the insufflation fluid from the insufflator to the bypassvalve; a second conduit coupled to the first channel of the bypass valveand configured to facilitate delivery of the insufflation fluid from thebypass valve to the patient cavity via a first medical appliance; and athird conduit coupled to the second channel of the bypass valve andconfigured to facilitate delivery of the insufflation fluid from thebypass valve to the patient cavity via a second medical appliance. 14.The system of claim 13, wherein: the first medical appliance is atrocar; and the trocar comprises a pressure sensor configured todetermine a pressure measurement indicative of a pressure of the patientcavity.
 15. The system of claim 13, wherein the second medical applianceis one from the set comprising: an insufflation needle; and a hassontrocar.
 16. The system of claim 13, wherein the insufflator comprises apressure sensor configured to determine, based on information deliveredvia the second flow path, a pressure measurement indicative of apressure of the patient cavity.
 17. The system of claim 13, wherein theinsufflator comprises: a processor; and a computer readable mediumhaving logic stored thereon, the logic operable, when executed by theprocessor, to supply insufflation fluid to a patient cavity based on apressure measurement.
 18. The system of claim 14, wherein theinsufflator is configured to supply the insufflation fluid to thepatient cavity based on the pressure measurement determined by thepressure sensor of the trocar in response to determining that theinsufflation fluid is being delivered to the patient cavity along thefirst flow path.
 19. The system of claim 16, wherein insufflator isconfigured to supply the insufflation fluid to the patient cavity basedon the pressure measurement determined by the pressure sensor of theinsufflator in response to determining that the insufflation fluid isbeing delivered to the patient cavity along the second flow path. 20.The system of claim 17, wherein the logic is further operable, whenexecuted by the processor, to instruct a pressure sensor of theinsufflator to take a pressure measurement in response to determiningthat insufflation fluid is not being supplied to the patient cavity.